Intestinal colonization of a human subject by vancomycin-resistant Enterococcus faecium

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Objective: To study the ability of two strains of vancomycin-resistant Enterococcus faecium to colonize the human intestine. Methods: A single human subject ingested separately two strains of vancomycin-resistant E. faecium isolated from a pig and a chicken. The feces were cultured on selective medium. Prior to ingestion no vancomycin-resistant cocci were present in the feces. Ingestion of 10 4-10 5 CFU resulted in either no colonization or isolation only after enrichment. Ingestion of 10 7 CFU of one strain resulted in colonization for a period of nearly 3 weeks, with fecal counts at times in excess of 10 6 CFU/g. Ingestion of similar numbers of the other strain and reingestion of the first strain resulted in excretion in the feces for much shorter periods. When the fecal count of the ingested strains was greater than 10 4-10 5 CFU/g, the strains were isolated from swabs taken from perianal skin. Conclusions: Vancomycin-resistant E. faecium strains from pigs and poultry a re able to colonize the human gut and the perianal skin.